Provider Demographics
NPI:1942306592
Name:ST. FRANCIS HOSPITAL HOSPICE
Entity Type:Organization
Organization Name:ST. FRANCIS HOSPITAL HOSPICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:PERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-324-8500
Mailing Address - Street 1:1212 FRANCISCAN DR
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:62056-1778
Mailing Address - Country:US
Mailing Address - Phone:217-324-8584
Mailing Address - Fax:217-324-8701
Practice Address - Street 1:1212 FRANCISCAN DR
Practice Address - Street 2:
Practice Address - City:LITCHFIELD
Practice Address - State:IL
Practice Address - Zip Code:62056-1778
Practice Address - Country:US
Practice Address - Phone:217-324-8584
Practice Address - Fax:217-324-8701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2001170251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL370661236004Medicaid
IL370661236004Medicaid